Meeting a Tall Order: Recovery from a Severe Leg Injury

On September 7, 2006, the car in which 4-year-old Lio Spinelli was riding with his mom, Sasha, was struck from behind by a lorry on the M2 motorway in Kent, England. The tragic accident took Sasha’s life and left Lio with critical brain and leg injuries. “Lio had a severe growth plate fracture with extension of the fracture into the joint surface,” explains Roger F. Widmann, MD, Chief of Pediatric Orthopedic Surgery. “Because of his more pressing brain injuries, the orthopedic issues were not immediately addressed. He healed with closure of the growth plate in his knee, causing a progressive leg deformity. In addition, he had severe scarring inside his knee and the bone had healed in a position that wasn’t optimal, limiting range of motion and making it difficult for him to walk or participate in any activities.”

Surgeons overseas had recommended shortening Lio’s good leg and stopping the growth on the injured leg so that they would remain the same length. Lio and his father met with Dr. Widmann, who offered a different approach in which he would correct the growth plate problem and leg length discrepancy issues, and orthopedic surgeon Scott Rodeo, MD, who would address the extensive soft tissue work needed inside Lio’s knee joint. “They explained in breathtaking detail what they were going to do. They said that we may be pushing the envelope slightly, but that they thought it would work,” says Lio’s father, Martin Spinelli.

The surgeries were performed simultaneously in March 2007. Dr. Rodeo released adhesions and scar tissue and smoothed out the cartilage inside the knee in order to restore range of motion. “Because his growth plate had closed prematurely, a growth-blocking boney bar had formed across the growth plate and had to be removed – which we did in the second stage of the surgery,” explains Dr. Widmann. “We then filled in the gap with bone cement to prevent reformation of the bar and to allow for ongoing growth of the femur.”

“This was a tough injury for this child,” notes Dr. Rodeo. “His recovery has exceeded our expectations. Lio has near normal ability to bend his leg and he continues to grow normally. It’s gratifying to see how well he’s done.” It seems friends back in their neighborhood of Lewes, England, feel the same way. The local paper has taken to calling Lio “Lewes little miracle.”